Therapeutic effect on the change of gait performance in chronic calf myofascial pain syndrome: A time series case study

Objectives: To investigate the influence of the chronic calf myofascial pain syndrome [MPS] on gait performance and the effectiveness of myofascial treatment programs in order to inform the clinical management for this impairment. Methods: A female subject suffered from chronic knee and ankle pain for five years as a result of calf muscles MPS. The range of motion, pain intensity, and gait analysis were evaluated before and after myofascial pain therapy. The eight-week calf myofascial treatment programs included manual techniques, deep myofascial release, deep friction massage, and proprioceptive neuromuscular facilitation stretching, and a home program [self-stretching exercises]. Results: There were significant improvements in the ankle-dorsiflexion range of motion of the affected leg after treatment [P < 0.01]. A trend of moderate improvement in pain conditions were recorded both in resting and after work. Although the kinematic data of gait analysis were quite similar across treatments except for improved knee flexion angles, the kinetic findings revealed significant effectiveness of myofascial treatments. The decreased peak ground reaction forces [P < 0.001], improved peak joint moments of ankle dorsiflexion [P = 0.008], foot supination [P = 0.002], and knee extension [P = 0.009] were demonstrated during walking. Conclusions: The chronic muscle tightness caused by MPS is a factor influencing the joint motion and easily ignored by clinicians. This study investigated the influence of calf myofascial pain on gait performance. The quantitative gait analysis was highly valuable to clarify the influence of chronic calf tightness on the mobility of ankle and knee joints and to assess the effectiveness of myofascial treatments.